Osteoporosis is a growing public health problem as a consequence of its associated fractures, especially of the proximal femur. Although the focus in the past has been on the problem of osteoporosis in white women, there is increasing recognition that osteoporotic fractures also pose a threat to other populations. In 1995, for example, 6.5% of the total cost of osteoporotic fractures in this country, $901 million, was due to fractures in nonwhites. However, the epidemiology of bone loss and fractures in populations of Asian heritage is still poorly known, and most studies to date have been carried out overseas in China and Japan. Whether or not osteoporosis represents a potential problem among refugees from Vietnam, Cambodia or Laos is unknown. The goal of this proposal is to assess the skeletal status of Olmsted County residents orginally from Laos in order to help design prevention programs should osteoporosis prove to be common in this population. The specific aims of this study are as follows: 1) to provide health education on osteoporosis and on possible preventive measures such as dietary calcium, hormone replacement therapy and exercise; 2) to determine bone mineral density levels among the Laotian men and women residing in Olmsted County and to compare these with the distribution of bone density among white residents of the County and among residents from Cambodia and Vietnam; to examine the association between bone density and life-style and, for the women, reproductive factors; 4) on the basis of these data, to recommend strategies to prevent osteoporosis among Laotians; and 5) in follow-up at two-year intervals, to inquire what lifestyle changes have been made and to assess changes in BMD of the hip and spine.